Tag Archives: pediatrics

Recommendations for Pacifiers

By: Jessica Drake-Simmons M.S. CCC-SLP

Babies show a natural tendency to suck on fingers and thumbs from the time they are in utero.  Sucking provides comfort and is a natural way for babies to explore the environment.  Allowing a baby to suck on a pacifier can have the advantages of helping to sooth a fussy baby, providing a distraction and helping a baby fall asleep.   Additionally, pacifiers may help minimize reflux.  The Mayo Clinic suggests that a pacifier could help reduce the risk of sudden infant death syndrome when used at nap time and bedtime.

Baby nico on swingThe problem with pacifiers comes when little ones become dependent on them.  As a speech-language pathologist, seeing kids more frequently in their toddler years and beyond, I see some of the detrimental effects that persistent pacifier use can cause.  The preferred oral rest posture is having the lips closed, tongue placed up against the roof of the mouth, a slight space between the teeth and nasal breathing.  This oral rest posture supports dental alignment and wide rounded dental arches. Prolonged pacifier use (or other sucking habits) can cause a child’s teeth to be misaligned or not come in properly.

A study from Van Norman, 2001 found that 60% of dental malocclusions were related to sucking habits.  When the shape of the roof of the mouth is changed and dental malocclusions are created, kids can develop articulation errors such as a forward tongue position for production of /s/ (lisping).  Obstructing the mouth with a pacifier can negatively impact babbling and imitation of sounds.  Additionally, there is a correlation between pacifier use and increased incidence of ear infections.  Frequent ear infections are a common cause of speech and language delays.

Guidelines to follow for pacifier use:

  • The American Academy of Pediatrics recommends waiting to offer a pacifier until a baby is 3-4 weeks old when breast feeding is well established.
  • Don’t use the pacifier as a first line of defense. Try other strategies such as changing positions or rocking the baby to sooth them. pacifier
  • Use the appropriate size pacifier for your babies age in order to help maintain correct jaw alignment.
  • Recommendations vary between 6 months and 2 years for when it is appropriate to discontinue pacifier use. It can be easiest to wean the pacifier by the time a baby is 12 months.
  • Use pacifiers that are rounded on all sides. This allows for a more natural position of the tongue during non-nutritive sucking.

For help with discontinuing pacifier use: http://www.orofacialmyology.com/StopPacifier

To learn more about speech language-pathology and Easter Seals DuPage & Fox Valley visit eastersealsdfvr.org

Everyone Sitting at the Table: The Power of Family Meals

By: Emily Mitchell, Easter Seals DuPage & Fox Valley and Northern Illinois University Dietetic Intern & Candidate for Masters in Nutrition and Dietetics

When was the last time your entire family sat down for a meal together? You are an extremely influential role model for your child, and your actions and emotions are essential for your child’s growth and development. Your child learns through experiences and modeling behaviors, so try using meal time as a chance to work towards developmental milestones!

Family Style Meal Service

The environment in which meals are served can impact a toddler’s willingness to try new foods and develop healthy dietary patterns. Family style meals have been shown to be an effective approach in creating an environment conducive to establishing healthy behaviors in the home, as well as in schools and daycare facilities. Most importantly, family style meal service approaches mealtime as a learning experience.

The objectives of family style meal service include:

  • Helping children develop positive attitudes towards nutritious foods
  • Learning to engage in social eating situations
  • Developing healthy eating patterns

myplate_greenChild involvement is integral to the concept of family style meal service, and can be done by allowing children to do the following things:

  • Be the “produce picker” at the store
  • Assist with meal preparation
  • Set the table places
  • Engage in conversation during the meal
  • Assist with clean up

Involvement in meal time may look different for each child based on their developmental abilities. When establishing family meals, it is important that children are not only provided guidance through physical assistance and engaging in appropriate social exchanges, such as taking turns, but are also given age appropriate serving utensils and dishware to establish age appropriate portions.

Meal Time- It’s Not Just About Food and Nutrition!

Again, meal time is not solely about food and nutrition; it also provides parents the opportunity to model social, communication and motor skills. Approach mealtime as a learning experience and remember that meal time serves not only to help children develop positive attitudes towards nutritious foods, but also learn to engage in social eating situations, and develop motor skills.

In order to hone in on social, communication and motor skills, involving your child in meal time is key! Conversations during meal time provide an opportunity to enhance family connection and establish relationships among all members of the family. It is a chance to share information or news about your day.

Maggie_1.jpgBenefits and Barriers to Family Meals

Family meals have been shown to foster happy, well- adjusted kids. Research has shown that family meals have many benefits, including:

  • Opportunities for modeling healthy behaviors
  • Increase autonomy in children
  • Enhance communication and social skills
  • Heighten family connectedness
  • Develop motor skills
  • Encourage nutritious meals

Despite the many benefits of family meals, it can be trouble to do because of, child behavior problems, scheduling difficulties, and lack of self-efficacy in meal preparation.

What About My Child on Tube Feedings?

How do you involve everyone in the meal? Just as children consume food orally, your child on a tube feeding can use family meal time to socialize, interact, and learn. Have meal time conversations that are about more than the food. Look beyond the calorie nourishment of meal times and include your child receiving tube feedings in meal time, so they can receive the many qualities of meal times.

fun-with-food-035What is So Powerful About Meal Time?

The real power of meal time is the interpersonal quality. Kids like eating with their families, so allow for some fun! It is understandable that meal time may be frustrating at times, but try to make it as positive of an experience as possible. Dinner may be the one time during the day that a parent and child can share a positive experience—a yummy meal, a joke, or a story. Many children strive for autonomy, so as discussed previously, involve your kids in meal time and allow for learning and laughter! These special moments created at the table help gain momentum for your child’s development away from the table.

Your challenge–schedule time spent at the table with your family into your day!

If you find your child has nutrition problems including failure to thrive, obesity, poor feeding skills, sensory disorders, and gastrointestinal disorders or others schedule a nutritional evaluation with Easter Seals DuPage & Fox Valley today. Learn more at eastersealsdfvr.org/nutrition.

How to Prevent Your Baby From Getting a Flat Head

baby helmet

By: Bridget Hobbs, PT, DPT

You probably have seen them on babies in the mall, grocery store and at the park.  Baby helmets are everywhere!  Helmets have been used for a long time for safety with children that have seizures, but more recently they are also used to help mold babies’ heads that are flat back into a round shape.

Babies can have flat heads from crowding in-utero, which is very common with multiples.  However, there is an increasing number of cases of babies with flat head from positioning (or lack there-of) after they are born.   In fact, according to an article in the August 2013 issue of Pediatrics , 46.6 % of 440 infants studied from 7 to 12 weeks of age had positional plagiocephaly, or a flat head. Granted 78.3 % of children in the cohort study had a mild form of the condition; it does reveal that positional plagiocephaly is a very common occurrence these days.baby helmet

When your baby is born, her skull is very soft which has allowed her to travel through the birth canal.  They flexibility of the skull also allows for brain growth in the first years of life.  Because of this softness, the skull is very moldable.  Spending long periods of time in one position can lead to flatness of the side of the head (plagiocephaly) or back of the head (brachycephaly).

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The good news is that positional plagiocephaly is preventable.  Here are some tips that can help you manage your little ones’ head shape from day one.

  • Alternate the arm in which you carry your child. If you are right handed, it’s really tempting to just hold your baby in your left arm so it frees up the right hand to grab your cup of coffee or something out of the fridge.  However, when you just hold your baby in one arm, they are likely just using their neck muscles to look outward to one side.  Alternating which arm you use for carrying your baby encourages them to look both ways often, making their neck muscles strong and less likely to be tight on one side. Tightness on one side of the neck, otherwise known as torticollis, makes it difficult for your child to change their head position, which can lead to flat head.    In fact, many babies that have torticollis (tightness on one side of the neck) also have plagiocephaly (flat head).
  • When placing your baby down to sleep, alternate what side of the crib your baby’s head is on. This way, if baby is looking toward the door of the nursery or at a night light, they are alternating which side they are looking each night (or nap).  You can also switch which side of the changing pad you place your babies’ head when changing their diaper so they are looking both ways equally.  As a reminder, always place your child on their back to sleep.
  • Limit the time that your baby is in a container, for example car seats, strollers, bouncy seats and swings. Your baby does not have the ability to move her neck very much when placed in these containers, which can lead to tight neck muscles and flatness of the head.  As a mom of an infant myself, I know it is tempting to leave your child in the car seat when they fall asleep after being in the car.  Once in a while it is fine, and I am certainly guilty of it myself.  However, repeated naps in car seats can quickly become a problem.
  • Tummy time! I can’t say this enough…start tummy time early and do it often with your baby.  Some babies really don’t like it, but stick with it and they will gradually get used to it.  If they are really fussy, wait 1 hour after feeding to give their tummies time to settle after a meal.   For more tips on how to make tummy time easier for your child (and you!), refer to my previous blog “Yes! We Want Your Baby to Crawl!
Tummy time is important Photo by Lorae Mundt
Tummy time is a good way to prevent positional plagiocephaly. Photo by Lorae Mundt

Because of the “back to sleep” program, which started in 1992, babies are not on their tummies as much.  The back to sleep program has done an excellent job at reducing SIDS, but the tradeoff is that many children get plagiocephaly (flat heads) and torticollis (tight necks) from not spending enough play time on their tummy.   This often leads to physical therapy and a possible appointment at your nearest orthotist or baby helmet clinic.

Luckily, there are many clinics in the area that treat children with torticollis and plagiocephaly.  There are even specialized clinics that just fit babies for helmets and monitor their progress with head shape.  Most children have to wear baby head shaping helmets for a few months before they see good results with their head shape.

Pediatric physical therapy helps with stretching out tight muscles and strengthening weak neck muscles.   It also helps your child with their gross motor skills, such as rolling, crawling and standing, which can often be impacted by tight neck muscles and/or a flat head.   If your child has a flat head and/or tight neck muscles, schedule a physical therapy evaluation with a pediatric physical therapist at Easter Seals Dupage & Fox Valley by calling 630.261.6287.